Impact of psychological health on peripheral endothelial function and the HPA-axis activity in healthy adolescents

  • Yun Chen
    Corresponding author. Wallenberg Laboratory, Bruna Stråket 16, The Sahlgrenska Academy and University Hospital, University of Gothenburg, SE 41345 Gothenburg, Sweden.
    Department of Molecular and Clinical Medicine/Clinical Physiology, The Sahlgrenska Academy and University Hospital, University of Gothenburg, SE 41345 Gothenburg, Sweden
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  • Walter Osika
    Department of Clinical Neuroscience, Karolinska Institute, SE 17177 Stockholm, Sweden
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  • Frida Dangardt
    Department of Molecular and Clinical Medicine/Clinical Physiology, The Sahlgrenska Academy and University Hospital, University of Gothenburg, SE 41345 Gothenburg, Sweden
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  • Peter Friberg
    Department of Molecular and Clinical Medicine/Clinical Physiology, The Sahlgrenska Academy and University Hospital, University of Gothenburg, SE 41345 Gothenburg, Sweden
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      • Reduced endothelial function is inversely related to negative emotions in boys.
      • Blunted cortisol awakening response is related to high level of negative emotions.
      • Positive self-concept during adolescence might be protective.


      Background and aims

      The development of adolescence psychological health over a 3-year period and its relationship to peripheral endothelial function and the hypothalamic-pituitary-adrenal (HPA)-axis activity were examined in a cohort of healthy adolescents in a longitudinal study.


      A total of 162 adolescents (94 females) participated in both baseline (mean age 14.5 ± 1 years) and three-year follow-up studies. Psychological health was evaluated by self-report using the Beck Youth Inventories of Emotional and Social Impairment and the psychosomatic problem scale. Peripheral endothelial function was assessed using a peripheral artery tonometry device. The HPA-axis activity measured as cortisol awakening response (CAR) was assessed only at follow-up by collecting two saliva samples, immediately after awakening and 15 min later. Physical activity, smoking and parental education were assessed by questionnaires.


      Adolescents reported increased depression and decreased anger over three years, while only females reported increased psychosomatic complaints. Reduced peripheral endothelial function was associated with high level of anger (β = −0.332, p = 0.018) and disruptive behaviour (β = −0.390, p = 0.006) over three years in males, but not in females, after adjusting for covariates. Blunted cortisol awakening response was associated with high level of anxiety (β = −0.235, p = 0.017), depression (β = −0.203, p = 0.038), anger (β = −0.185, p = 0.048), and low level of self-concept (β = 0.289, p = 0.002) after adjusting for covariates.


      High level of negative emotions during adolescence may have adverse effects on peripheral endothelial function and the regulation of the HPA-axis activity, while high level of self-concept might be protective.


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